Active NPI
Jacqueline Yuven Mabu
- Pharmacist
- Easton, MD
National Provider Identifier
1710236203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28377
- Practice address
- 28528 Marlboro Ave
Easton, MD 21601-2792 - Phone
- (410) 690-7203
- NPI assigned
- Aug 30, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | |||
| Pharmacist | 183500000X | 28377 | MD | Primary |
Addresses
Primary practice location
28528 Marlboro Ave
Easton, MD 21601-2792
Mailing address
723 N Chester St
Baltimore, MD 21205-2304
Phone (240) 467-8990
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28377 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640649600000",
"number": "1710236203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "723 N CHESTER ST",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212052304",
"telephone_number": "240-467-8990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "28528 MARLBORO AVE",
"city": "EASTON",
"state": "MD",
"postal_code": "216012792",
"telephone_number": "410-690-7203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUVEN MABU",
"first_name": "JACQUELINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-30",
"last_updated": "2021-12-28",
"certification_date": "2021-12-28",
"status": "A"
},
"taxonomies": [
{
"code": "374U00000X",
"taxonomy_group": "",
"desc": "Home Health Aide",
"state": null,
"license": null,
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MD",
"license": "28377",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Easton, MD
- Young Men's Christian Association of the Chesapeake, Inc.
- Barbara K Young, LCSW-C
- Joshua Lee Young, OTA
- Munib Yousuf, M.D.
- Michele Fox Yoviene, PT
- Zenbees Psychiatry and Wellness Services
- Ali Marie Zentgraf Era, DNP, CRNP, FNP-C
- Xingyue Zhang, RD, LDN
- Kathleen Anne Ziegler, DO
- Lauren Strady Zimmer, D.O.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.